Advancing Sustainability of Evidence-Based Treatments in Community Mental Health

促进社区心理健康循证治疗的可持续性

• 批准号: 10535362
• 负责人: Laurel D Sarfan
• 金额: $ 6.72万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-21 至 2025-01-20
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10535362
• 关键词: Automobile Driving; California; Circadian Dysregulation; Communities; Community Mental Health Centers; Complex; Effectiveness; Environment; Equation; Evaluation; Evidence based treatment; Fellowship; Goals; Individual; Infrastructure; Intervention; Interview; Investigational Therapies; Knowledge; Linear Models; Measures; Mediating; Mediation; Mediator of activation protein; Mental Health; Mental Health Services; Mentorship; Methods; Modeling; National Institute of Mental Health; Outcome; Parents; Patient-Focused Outcomes; Patients; Perception; Phase; Provider; Questionnaires; Randomized; Research; Research Design; Research Personnel; Research Training; Resources; Sleep Disorders; Strategic Planning; Structure; Testing; Training; United States National Institutes of Health; Universities; bone; career; community setting; design; implementation barriers; implementation framework; implementation intervention; implementation outcomes; implementation science; improved; post implementation; practice setting; prevent; programs; recruit; response; routine practice; severe mental illness; sustainability framework; theories; training opportunity

Project Summary/Abstract Too many patients do not receive evidence-based treatments (EBTs) for mental health problems. In response, implementation science has rapidly advanced to bring EBTs to routine practice settings, and thereby improve patient outcomes. Unfortunately, research on sustainability of EBTs remains alarmingly limited. This is concerning, given that EBT activities and benefits regularly decline post-implementation. To prevent these declines, research on sustainability is urgently needed. Per NIMH’s Strategic Plan 4.2, this F32 will advance research on sustainability – namely, sustainability (a) outcomes, (b) predictors, and (c) mechanisms – by leveraging an ongoing, parent R01 (R01MH120147). The R01 focuses on implementation of an EBT in 10 of California’s community mental health centers (CMHCs). Specifically, the CMHCs partnered with the R01 team to implement the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) for individuals with serious mental illness. Additionally, the R01 was designed to test whether manipulating TranS-C to “fit” the CMHC context would improve implementation outcomes by randomizing CMHCs to deliver Standard TranS-C or Adapted TranS-C. Thus, the R01’s infrastructure allows this F32 to test three primary aims. Consistent with Shediac-Rizkallah and Bone’s sustainability framework, Aim 1 will evaluate qualitative and quantitative sustainability outcomes of TranS-C, with respect to continued (a) activities, (b) benefits, and (c) capacity. Aim 2 will use hierarchical linear modeling to evaluate whether manipulating treatment fit to context predicts sustainability outcomes. Aim 3 will use structural equation modeling to test possible mediators – specifically, provider perceptions of fit (i.e., acceptability, appropriateness, and feasibility) – of the relation between manipulated treatment fit and sustainability outcomes. To accomplish these aims, the applicant will receive training in: (1) sustainability of EBTs, (2) advanced quantitative analysis, (3) mechanistic research design, and (4) qualitative and mixed methods approaches. The research and training opportunities offered by this fellowship will be supported by the thriving research environment of University of California, Berkeley and mentorship from the applicant’s Sponsor (Dr. Allison Harvey) and expert Consultants (Drs. Shannon Wiltsey Stirman, Cara Lewis, and Sophia Rabe-Hesketh). Collectively, this F32 fellowship will support the applicant’s career goals of becoming an independent investigator in implementation science with a program of research that evaluates the predictors, mechanisms, and outcomes of implementation and sustainability of EBTs in community settings.

项目概要/摘要 太多的患者没有接受针对心理健康问题的循证治疗（EBT）。 实施科学迅速发展，将 EBT 引入常规实践环境，并由此得到改进 不幸的是，关于 EBT 可持续性的研究仍然非常有限。 鉴于 EBT 活动和福利在实施后经常下降，因此值得关注。 下降，迫切需要对可持续性进行研究，根据 NIMH 的战略计划 4.2，F32 将取得进展。 可持续性研究——即可持续性（a）结果、（b）预测因素和（c）机制—— 利用正在进行的母公司 R01 (R01MH120147) R01 侧重于在 10 年内实施 EBT。 具体来说，加州社区心理健康中心 (CMHC) 与 R01 团队合作。 为个人实施睡眠和昼夜节律障碍跨诊断干预 (TranS-C) 此外，R01 的设计目的是测试操纵 TranS-C 是否“适合”该患者。 CMHC 环境将通过随机化 CMHC 来提供标准 TranS-C 来改善实施结果 或改编的 TranS-C 因此，R01 的基础设施允许 F32 测试三个主要目标。 Shediac-Rizkallah 和 Bone 的可持续发展框架，目标 1 将进行定性和定量评估 TranS-C 的可持续性成果，涉及持续的 (a) 活动、(b) 效益和 (c) 目标 2。 将使用分层线性模型来评估操纵治疗是否适合上下文预测 目标 3 将使用结构方程模型来测试可能的中介因素 - 具体来说， 提供者对适合度的看法（即可接受性、适当性和可行性）——对两者之间关系的看法 为了实现这些目标，申请人将获得操纵的治疗适合度和可持续性结果。 培训：(1) EBT 的可持续性，(2) 高级定量分析，(3) 机制研究设计，以及 (4) 定性和混合方法方法提供的研究和培训机会。 奖学金将得到加州大学伯克利分校蓬勃发展的研究环境的支持 申请人赞助商（Allison Harvey 博士）和专家顾问（Shannon Wiltsey 博士）的指导 Stirman、Cara Lewis 和 Sophia Rabe-Hesketh 共同表示，这项 F32 奖学金将支持申请人的研究。 成为具有研究计划的实施科学的独立研究者的职业目标 评估 EBT 的实施和可持续性的预测因素、机制和结果 社区设置。